Potential Price Reductions for Cancer Medicines on The WHO Essential Medicines List. (European Cancer Congress, January 2017, Amsterdam; Abstract #1032; Poster #151)
(2017; 2 pages)

Abstract

Background: The majority of cancer diagnoses occur in low and middle income countries, where there were an estimated 14 million incident cases in 2012, and a projected 22 million cases by 2035. Global spending on oncology reached $100 billion in 2014. High prices of cancer treatments are a barrier to access in low and middle income countries, where monthly prices often exceed annual incomes. Over 17 million people with HIV/AIDS are on treatment with low-cost generic antiretrovirals. We investigated the feasibility of similar price reductions in medicines for cancer. The World Health Organization’s Essential Medicines List (WHO, EML) lists 39 cancer medicines that are a high priority for treatment worldwide. The cost of active pharmaceutical ingredient (API) is a central component of drug cost of production.

Methods: Current unit prices in the UK, Spain, and India were collected for cancer drugs in the WHO EML using public databases. Data on per-kilogram cost of exported API were retrieved from an online database of Indian export logs, and used in an established costing algorithm to derive estimates for generic prices (‘target prices’) assuming robust competition: per-dose API costs were calculated, to which excipient costs of US$2.63 per kg of finished pharmaceutical product and per-tablet costs of production of US$0.01 were added, plus a 10% profit margin accounting for a 26.6% average tax on profits (assuming manufacture in India.)

Results: Calculated target prices for tablets were median 1% above prices in India, 85% below current prices in the UK, 89% below prices in Spain, and 86% below prices in US (Veterans Affairs pricing). For injectable formulations, the lowest current price found for finished pharmaceutical products in India were median 12% above the estimated cost of API, and 94% above final product current prices in Spain, 98% above prices in the UK, and 87% above prices in the US (Veterans Affairs pricing).

Conclusion: Mass production of cancer drugs on the World Health Organization Essential Medicines List could significantly lower prices. Significant reductions in cancer drug prices could allow substantial expansion of cancer treatment coverage, across a wide range of countries.

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